Age-related macular degeneration (AMD) is the most common visual impairment in persons over 50 years of age. It has been estimated that 1 in 3 individuals over 75 years of age and 1 in 30 individuals over 52 years of age are affected by AMD. The deficits in visual function as a result of this disease affecting the central retina are debilitating, as individuals lose their abiity to carry out many of their daily activities that require resolving fine spatial details. Our previous studies have shown that training with oculomotor control exercises significantly increases reading speeds in patients with AMD. In the proposed study, we will examine whether these training exercises are effective when practiced at home. In Phase 1, we will develop a standardized user-friendly, Web-based platform that will allow patients to easily self-administer training exercises. The software platform will be designed to automatically choose the appropriate exercises based on a patient's previous performance, run the training exercise, and collect performance data into a universal patient data file. In Phase 2, the platform will be teste in two settings: in standard clinical rehabilitation practice and in the patient's home. Reading outcomes in the two settings will be compared. We will recruit 60 patients per year for each of the three years for Phase 2 of the study. Half of these patients will be assigned to the Clinic Training Group, while the other half will be assigned to At-home Training Group. For all patients, three assessments will be taken: at baseline, after 1 month, and after 2 months of training. We will compare reading outcomes to assess the roles of feedback versus the role of frequent available practice. Because of the extensive cost and clinical resources required for vision rehabilitation, it is critical to determine whether the training program can be made less expensive, but as effective, when it is self-trained. If we demonstrate the utility of at-home practice, clinical facilities and therapists' time can be made available for those activities requiing face-to-face contact. PUBLIC HEALTH RELEVANCE: Age-related macular degeneration (AMD) is the most common visual impairment in persons over 50 years of age. It has been estimated that 1 in 3 individuals over 75 years of age and 1 in 30 individuals over 52 years of age are affected by AMD. The deficits in visual function as a result of this disease affecting the central retina are debilitating, as individuals lose their abiity to carry out many of their daily activities that require resolving fine spatial details. Our previous studies have shown that training with oculomotor control exercises significantly increases reading speeds in patients with AMD. In the proposed study, we will examine whether these training exercises are effective when practiced at home. Because of the extensive cost and clinical resources required for vision rehabilitation, it is critical to determine whether the traiing program can be made less expensive, but as effective, when it is self-trained.